This article investigates the conceptual distinctions between therapy and various forms of human enhancement. It begins by proposing a typology of human enhancements in order to make more rigorous and grounded discussions about the distinction between therapy and enhancement. Three types of human enhancement are proposed: 1) engineering traits of accepted value, 2) engineering traits of contested value and 3) radical transhuman enhancements. Subsequently, the paper explores the distinctions between the ethical justifications that are advanced for therapeutic interventions, comparing them with human enhancements, concluding that the salient characteristic of health-related suffering enables enhancement to gain legitimacy from the perspective of traditional medical ethics. Finally, the paper considers a number of practical obstructions to the realization of radical transhuman enhancements. Specifically, it discusses procedural obstacles to approving experimental medical research for human enhancements, the likely commercialization of human enhancements that would ensue from their development, and the need to develop experimental medical interventions via animal models.
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